New Patient Forms

New Patient Forms

Become a Patient


Welcome to Community Health Connections!

Below is a list of forms that you will receive at your first visit and will be asked to either fill-out, review or sign. You are welcome to download and print these forms.

All forms are available in English, Spanish and Portuguese.

If you have any questions, please call our Patient Call Center at 978-878-8100.

If you have questions about specific insurance plans that we accept, call the our Patient Call Center at 978-878-8100.

If you don't have insurance, the Patient Services team can be reached by calling the main CHC number 978-878-8100 and choosing option 6 for health insurance enrollment.

Our Patient Services Team is here to help you navigate and obtain the best and most cost-effective health insurance. We can help you apply for the health insurance that makes the most sense for you and your family. Many individuals and families can get help paying for health coverage. Our trained and certified Patient Services staff is here to answer your questions and help you apply for: MassHealth, The Health Safety Net, ConnectorCare and other insurances through the Massachusetts Health Connector, MassHealth Buy-In Application, SACA – Senior Application (65 and older). 

CHC also offers a Discounted Sliding Scale Fee, which can be discussed with our Patient Services staff.